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Mukesh Kapila: the International Humanitarian

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Mukesh Kapila: the International Humanitarian BMJ 2019;364:l649 doi: 10.1136/bmj.l649 (Published 27 February 2019) Page 1 of 2 Observations BMJ: first published as 10.1136/bmj.l649 on 27 February 2019. Downloaded from OBSERVATIONS BMJ CONFIDENTIAL Mukesh Kapila: The international humanitarian What is your pet hate? Cowardice mixed with hypocrisy. What is the worst job you have done? Standing at the edge of the Kagera river and counting the number of dead bodies washing into Lake Victoria—around 100 an hour, hour after hour—and inputting the data into epidemiological modelling to estimate mortality from the Rwandan genocide in 1994. Do doctors get paid enough? Yes. Even somewhat too much at the higher grades. http://www.bmj.com/ What unheralded change has made the most difference in your field? Cash, including electronic cash, instead of laborious and expensive in-kind relief provision of food etc, to people in humanitarian crises such as disasters and wars. I saw how the on 28 February 2019 by guest. Protected copyright. [Image: Duncan Smith] Turkish Red Crescent uses cash to bring hope and help to Syrian refugees and the dignity that this reignites when people are enabled to make their own choices. Biography What is your guiltiest pleasure? Mukesh Kapila, 64, is professor of global health and humanitarian affairs at the University of Manchester. He qualified in medicine and public health, For a properly guilty pleasure the ratio of guilt to pleasure should working for the NHS in Oxford, Cambridge, and London before being drawn into international humanitarian affairs. As a British government official in the be at least 2:1. My guilty pleasure is New York cheesecake. I’m 1990s he dealt with the genocides in Rwanda and Bosnia-Hercegovina. Serving a diabetic, which fosters the primary guilt, and then injecting as the head of the United Nations in Sudan in 2003-04 he witnessed mass an extra bolus of insulin reinforces the guilt. This happens twice crimes against humanity in Darfur. His strong protests led to his expulsion and to writing Against a Tide of Evil, a book documenting what was then a year only. For the rest of the year I just look at cheesecake confirmed by the International Criminal Court as genocide. “We can argue the and feel guilty. words, but that would be no consolation to those people who were affected,” he says. He has served as a member or an adviser to many international bodies and was appointed a CBE in 2003. What personal ambition do you still have? To work for a world where no people with diabetes die just What was your earliest ambition? because they can’t afford insulin. Currently, tens of thousands To be an actor. Hankering for that helped me navigate through do so around the world. a life that has witnessed, in equal measure, so much tragedy and absurdity. Where are or when were you happiest? Floating down the Zambezi river in a country boat with a bottle What do you regret most in your career? of cold beer, smug that the crocodiles whose eyes glinted in the Not giving Slobodan Milosevic (Serbian president who died in darkness couldn’t get me—but with just a slight frisson that the Hague during his trial for war crimes and genocide) a robust they might jump up . piece of my mind when I met him in Belgrade during the height of the war. For personal use only: See rights and reprints http://www.bmj.com/permissions Subscribe: http://www.bmj.com/subscribe BMJ 2019;364:l649 doi: 10.1136/bmj.l649 (Published 27 February 2019) Page 2 of 2 OBSERVATIONS How is your work-life balance? plagued apartments were cutting up their precious clothes for menstrual hygiene purposes. Sanitary products should be an There is none. I felt mightily liberated when I gave up on this, essential part of humanitarian relief provision. BMJ: first published as 10.1136/bmj.l649 on 27 February 2019. Downloaded from knowing it to be a hopeless struggle. I then began to enjoy life and work, both in extremes. The secret to a good, unbalanced life is to be prepared for the consequences of your choices—and What do you usually wear to work? to grin and bear them. The first things I find in the morning: usually an ill assorted match of shirt, tie, jacket, and trousers. I’m well known for being What would be on the menu for your last the worst dressed person in town. But I also have a special category of clothes that I reluctantly wear when calling on supper? government leaders or ambassadors, which I do a lot in my job. I’d probably replicate my last supper in Sudan, hosted by the French ambassador, on my expulsion in 2004 as the head of the Which living doctor do you most admire, United Nations there for having the temerity to speak up against the Darfur genocide—the most seminal experience of my life. and why? Velouté d’épinards (with William Fevre Chablis 2002), eventail Tom Catena, a US physician who has practised for the past de volaille aux champignons (with Domaine les Salices Syrah decade in the remote Nuba Mountains of Sudan (see https:// 1998), and crème caramel (with Monbazillac 1996). www.bmj.com/content/346/bmj.f759). He’s the most stubborn man I know, and it was an honour to visit him and witness his What television programmes do you like? extraordinary courage in the face of terrible genocidal violence. He was awarded the 2017 Aurora Prize for Awakening Historical dramas—preferably inaccurate ones. That way one Humanity. can appreciate history as it should have been. What book should every doctor read? What was your best career move? Burmese Days (1934) by George Orwell. As a child in India I Giving up clinical medicine (I didn’t like the sight of blood), to read about the British colonial administrator who lived get into global public health and then international humanitarian somewhere up the Irrawaddy river. He received his bundled-up work. copies of the Times three months late by boat. Instead of reading the latest issue first, as a lesser mortal would have done, our What new technology or development are indomitable bastion of the empire read his newspapers (after you most looking forward to? getting them ironed, of course) in strict order, starting with the http://www.bmj.com/ oldest. Thus he was systematically informed—three months Oral insulin, for personal reasons. So far I’ve injected myself late, but at least consistently late. I resolved then and there that some 36 000 times (as well as at least 50 000 pricks for I must come to the UK to benefit from the unique education measuring glucose), and it’s very tedious. that produced such characters. How do you keep fit and healthy? Summarise your personality in three I walk when I can—difficult, in the smog ridden cities I visit in words on 28 February 2019 by guest. Protected copyright. my extensive travels. Also, fitful visits to the gym whenever I Constantly tries, often fails. (Four words, sorry.) stay in a hotel, which is about 10 days a month. I manage perhaps 4000 steps a day on average, far short of the recommended 10 000. Is the thought of retirement a dream or a nightmare? What single change would you like to see Definitely a nightmare. I’d like to continue to challenge myself made to the NHS? and those around me for as long as they can tolerate me, and preferably beyond. Value clinical medical and health skills more, and put them back in charge of running the NHS. If you weren’t in your present position What would you say to your former what would you be doing instead? student self? I’d write another book (published posthumously) saying everything I couldn’t in earlier books because of the Official “Why do you work too hard?” It probably made little difference Secrets Act, contractual obligations, personal sensitivities, etc. to how my life evolved. Imagine where I could be now if I’d practised more sloth. What poem, song, or passage of prose To whom would you most like to would you like at your funeral? apologise? “Man’s inhumanity to man,” in the 1784 Robert Burns poem Man Was Made to Mourn: a Dirge. I’d like people to mourn To the girls and women who endured the siege of Sarajevo properly by being thoroughly depressed when I go. during the 1992-95 Bosnian war. I’m sorry that it took us too long to recognise that women stranded up in high floor, sniper For personal use only: See rights and reprints http://www.bmj.com/permissions Subscribe: http://www.bmj.com/subscribe.
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